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Gastric aspiration and sleeping position in infancy and early childhood
1Forensic Science Centre, University of Adelaide, Women's and Children's Hospital, South Australia, Australia. byardr01@forensic.sa.gov.au
Insights
The study found no evidence that the supine sleeping position increases infant deaths from gastric aspiration. Infants found in the prone position with vomitus showed significant airway aspiration, unlike those in the supine position.
Area of Science:
- Pediatric Safety
- Mortality Studies
- Gastroenterology
Background:
- Infant sleep position recommendations have raised concerns about potential increases in gastric aspiration deaths.
- This study investigates the association between infant sleep position and gastric aspiration in mortality cases.
Observation:
- A review of 196 infant and early childhood deaths over 9 years was conducted.
- The study examined the incidence of significant gastric aspiration in relation to sleep position.
Findings:
- Significant gastric aspiration was identified in three cases, all involving infants found in the prone (face-down) position, often with vomitus.
- No significant gastric aspiration was found in infants who died in the supine (back) or side-sleeping positions.
- No demonstrable increase in gastric aspiration deaths was observed in South Australia during the study period.
Implications:
- The findings do not support concerns that the supine sleeping position increases the risk of significant gastric aspiration.
- This research may inform safe infant sleep guidelines and public health messaging regarding sleep position and aspiration risk.
Abstract:
Concern has been expressed that the recommendation of supine sleeping position for infants would result in an increase in deaths due to gastric aspiration. A review of 196 cases of infant and early childhood death in children under 3 years of age, occurring over a 9-year period (September 1989 to August 1998) was undertaken to ascertain how many cases of significant gastric aspiration had occurred. Extensive and widespread filling of the airways/alveoli with gastric contents was found in three infants/young children aged 5, 6 and 30 months, respectively. In each instance the body had been found lying face down (prone), with the face in a pool of vomitus in at least one case. No cases of significant gastric aspiration were found in infants who had been found lying on their sides or backs (supine). In addition, no significant increase in numbers of infant and early childhood deaths in South Australia due to gastric aspiration over this time could be demonstrated. Concerns that the supine rather than the prone position is more likely to result in significant gastric aspiration are not supported by this study.